Left atrial fibrosis: an essential hallmark in chronic mitral regurgitation

Chronic mitral regurgitation (MR) is the second valvular heart disease for incidence, which worsening severity gradually affects all cardiac chambers and leads to poor outcome if untreated. The recent development of minimally invasive surgical techniques and percutaneous intervention has reduced the...

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Bibliographic Details
Main Authors: Maria Concetta Pastore, Giulia Elena Mandoli, Aleksander Dokollari, Gianluigi Bisleri, Matteo Lisia, Luna Cavigli, Flavio D’Ascenzi, Marta Focardi, Matteo Cameli
Format: Article
Language:English
Published: Media Med Publicis 2021-03-01
Series:Romanian Journal of Cardiology
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Online Access:https://www.romanianjournalcardiology.ro/wp-content/uploads/2021/03/RRC_art-6-1.pdf
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Summary:Chronic mitral regurgitation (MR) is the second valvular heart disease for incidence, which worsening severity gradually affects all cardiac chambers and leads to poor outcome if untreated. The recent development of minimally invasive surgical techniques and percutaneous intervention has reduced the operative risk, allowing a more confident referral of these patients for intervention. Therefore, there is a growing need of reliable markers to select the best therapeutic strategies and to identify the optimal timing for intervention. Myocardial fibrosis (MF) gradually occurs as a result of left atrial and ventricular (LA and LV) remodeling due to MR pressure and volume overload. It has been identified as an index of clinical outcome and arrhythmic risk in patients with MR. Particularly, the assessment of LA fibrosis not only allows to define different MR etiology, but also was associated with prognosis and atrial fibrillation (AF) burden. Nowadays, noninvasive estimation of MF is possible through the use of advanced imaging modalities, particularly cardiac magnetic resonance and speckle tracking echocardiography. This review discusses the role of LA fibrosis as a diagnostic and prognostic marker in patients with MR and its quantification by noninvasive multimodality cardiac imaging.
ISSN:1220-658X
2734-6382